| NPI | 1861431793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX H9167) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MT 100607) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2023-09-14 |